Home-based family caregiver-delivered music and reading interventions for people living with dementia (HOMESIDE trial): an international randomised controlled trial

Felicity Anne Baker; Vanessa Pac Soo; Jodie Bloska; Laura Blauth; Anna A Bukowska; Libby Flynn; Ming Hung Hsu; Edyta Janus; Kjersti Johansson; Tone Kvamme; Nicola Lautenschlager; Hayley Miller; Jonathan Pool; Agnieszka Smrokowska-Reichmann; Karette Stensæth; Kate Teggelove; Sven Warnke; Thomas Wosch; Helen Odell-Miller; Karen Lamb; Sabine Braat; Tanara Vieira Sousa; Jeanette Tamplin

doi:10.1016/j.eclinm.2023.102224

Home-based family caregiver-delivered music and reading interventions for people living with dementia (HOMESIDE trial): an international randomised controlled trial

EClinicalMedicine. 2023 Oct 2:65:102224. doi: 10.1016/j.eclinm.2023.102224. eCollection 2023 Nov.

Authors

Felicity Anne Baker^{1

2}, Vanessa Pac Soo^{3

4}, Jodie Bloska⁵, Laura Blauth⁶, Anna A Bukowska⁷, Libby Flynn¹, Ming Hung Hsu⁵, Edyta Janus⁷, Kjersti Johansson², Tone Kvamme², Nicola Lautenschlager^{8

9}, Hayley Miller¹, Jonathan Pool⁵, Agnieszka Smrokowska-Reichmann⁷, Karette Stensæth², Kate Teggelove¹, Sven Warnke⁶, Thomas Wosch⁶, Helen Odell-Miller⁵, Karen Lamb^{3

4}, Sabine Braat^{3

4}, Tanara Vieira Sousa¹, Jeanette Tamplin¹

Affiliations

¹ Creative Arts and Music Therapy Research Unit, The University of Melbourne, Australia.
² Centre for Research in Music and Health, Norwegian Academy of Music, Norway.
³ Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Australia.
⁴ MISCH (Methods and Implementation Support for Clinical Health) Research Hub, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia.
⁵ Cambridge Institute for Music Therapy Research, Anglia Ruskin University, United Kingdom.
⁶ Institute for Applied Social Sciences, Music Therapy Lab, Technical University of Applied Sciences Würzburg-Schweinfurt, Germany.
⁷ Institute of Applied Sciences, University of Physical Education in Krakow, Poland.
⁸ Academic Unit for Psychiatry of Old Age, Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia.
⁹ North Western Mental Health, Royal Melbourne Hospital, Melbourne, Victoria, Australia.

Abstract

Background: Music interventions provided by qualified therapists within residential aged care are effective at attenuating behavioural and psychological symptoms (BPSD) of people with dementia (PwD). The impact of music interventions on dementia symptom management when provided by family caregivers is unclear.

Methods: We implemented a community-based, large, pragmatic, international, superiority, single-masked randomised controlled trial to evaluate if caregiver-delivered music was superior to usual care alone (UC) on reducing BPSD of PwD measured by the Neuropsychiatric Inventory-Questionnaire (NPI-Q). The study included an active control (reading). People with dementia (NPI-Q score ≥6) and their caregiver (dyads) from one of five countries were randomly allocated to caregiver-delivered music, reading, or UC with a 1:1:1 allocation stratified by site. Caregivers received three online protocolised music or reading training sessions delivered by therapists and were recommended to provide five 30-min reading or music activities per week (minimum twice weekly) over 90-days. The NPI-Q severity assessment of PwD was completed online by masked assessors at baseline, 90- (primary) and 180-days post-randomisation and analysed on an intention-to-treat basis using a likelihood-based longitudinal data analysis model. ACTRN12618001799246; ClinicalTrials.govNCT03907748.

Findings: Between 27th November 2019 and 7th July 2022, we randomised 432 eligible of 805 screened dyads (music n = 143, reading n = 144, UC n = 145). There was no statistical or clinically important difference in the change from baseline BPSD between caregiver-delivered music (-0.15, 95% CI -1.41 to 1.10, p = 0.81) or reading (-1.12, 95% CI -2.38 to 0.14, p = 0.082) and UC alone at 90-days. No related adverse events occurred.

Interpretation: Our findings suggested that music interventions and reading interventions delivered by trained caregivers in community contexts do not decrease enduring BPSD symptoms.

Funding: Our funding was provided by National Health and Medical Research Council, Australia; The Research Council of Norway; Federal Ministry of Education and Research, Germany; National Centre for Research and Development, Poland; Alzheimer's Society, UK, as part of the Joint Programme for Neurodegenerative Diseases consortia scheme.

Keywords: Alzheimer's disease; Behavioural and psychological symptoms of dementia; Dementia; Family caregivers; Music interventions; Randomised controlled trial.

Associated data

ClinicalTrials.gov/NCT03907748